This study investigated the quality of life among 2435 employees in Deqing County and Taizhou City during the COVID-19 epidemic in March 2020, shortly after their return to work. Our study found that most participants had returned to work, and employees in Taizhou where epidemic was more severe were more likely to worry about the epidemic and had relatively low quality of life compared with Deqing, a low risk area. The awareness of the COVID-19 was common and most people implemented some measures to protect themselves accordingly, which were also associated with a higher quality of life. Being married and having no isolation were associated with better quality of life, while worrying about the epidemic led to a reduced quality of life.
Our study participants had a higher mean EQ-5D utility value (0.990±0.033) compared with the results from previous studies(16, 21, 22), so was the average VAS score (93.5) (16, 21, 23). Moderate pain/discomfort and anxiety/depression were the common problems affecting quality of life in our study population, which was consist with results from some other studies (16, 21, 22). Our results showed that anxiety/depression was the main problem followed by pain/discomfort, which was consisted with the finding from the study by Liu et al(21) but was inconsistent with results from studies by Guan et al(16) and Zhang et al(22) with the same questionnaire of EQ-5D. There might exist healthy worker effect and also our study participants were younger compared with some other studies.
Our results also indicated that regular physical activity and keeping home ventilation were related to the better quality of life in Deqing. However, in Taizhou, worrying about the epidemic, wearing a mask, keeping home ventilation and marital status were associated with quality of life. Of these factors, wearing a mask, keeping home ventilation and be married had a protective impact on the quality of life.
Recent studies showed that anxiety and depression caused by COVID-19 was associated with people’s life quality (24–26). However, only 3.9% participants reported problems of moderate anxiety/depression, while about 50% felt worried about COVID-19 in our study. Therefore, we suspected that the low-intensity and continuous worry about the epidemic seemed not enough to cause anxiety and depression, but enough to have a negative impact on people's quality of life instead. Meanwhile, even during the quarantine, most people still regularly went out to purchase essential supplies. Some protective measures such as home ventilation and wearing a mask when going out could reduce the risk of infection and might comfort people's emotions, which might explain their associations with life quality at high risk area. Associations of physical activities and marital status with life quality were also observed in previous study in Chinese general population (27) (28), which were similar with ours. The findings of Zhang(25) suggested that, most people received increased support and spiritual solace from their friends and family members. Our result that single participants were more likely to had worse life quality than those be married supported this assumption, which suggested that the unmarried people were more vulnerable to a worse quality of life during the epidemic. Physical activity was related to better life quality in youth(29) as well as working-age population (30), which was also observed in our study.
The main strength of our study was the relatively large sample size of 2435 participants and we assessed quality of life during the epidemic just after those participants returned to work. This study had some limitations: 1) non-randomized sampling limits the generalization of the results; and 2) we used cross-sectional study design and there was no information on change of quality of life before and after the epidemic.